Psychosis due to systemic lupus erythematosus: characteristics and long-term outcome of this rare manifestation of the disease
Psychosis due to systemic lupus erythematosus: characteristics and long-term outcome of this rare manifestation of the disease
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DOI：
10.1093/rheumatology/ken260
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发表时间：
2008-10-01
期刊：
影响因子：
5.5
通讯作者：
Isenberg, D. A.
中科院分区：
文献类型：
--
作者：
Pego-Reigosa, J. M.;Isenberg, D. A.
目标。根据ACR神经精神（NP）综合征的命名法，确定SLE所致精神病的患病率、特征和长期预后。所有严格符合ACR定义的狼疮所致精神病患者均从我们的狼疮队列485例患者中确定并进行回顾性评估。11例（2.3%）患者被诊断为狼疮所致精神病。狼疮精神病在60例SLE患者的初始表现中出现，80%的病例在发病的第一年出现。所有患者在多系统狼疮活动的背景下出现精神病性症状，其中90%的患者有皮肤受累。我们患者的精神病活动与90%的狼疮活动的生物学标志物相关。其中10例出现apl。70%的患者在平均155个月的随访后表现出精神病症状的完全缓解。所有这些患者均出现了长期缓解。30%的患者出现慢性轻度精神病症状。狼疮引起的精神病是一种罕见的事件，通常发生在病程的早期，并与SLE的其他临床和生物学特征有关。强化免疫抑制治疗后的长期结果似乎是有利的。本报告强调了前瞻性多中心研究的必要性，以提高我们的知识，并帮助建立治疗这种罕见的狼疮并发症的指导方针。
Objective. To determine the prevalence, characteristics and long-term outcome of psychosis due to SLE defined according to the ACR nomenclature for neuropsychiatric (NP) syndromes.Methods. All the patients who strictly fulfilled the ACR definition for psychosis due to lupus were identified within the 485 patients of our lupus cohort and retrospectively evaluated.Results. Psychosis due to lupus was diagnosed in 11 (2.3%) patients. Lupus psychosis presented as the initial presentation of SLE in 60 of the patients and within the first year of the disease in 80% of the cases. All the patients developed psychotic symptoms within the context of multi-systemic lupus activity, with 90% of them having cutaneous involvement. Psychosis activity in our patients was associated with biological markers of lupus activity in 90% of the cases. The aPLS were observed in 10 of the cases. Seventy percent of our patients showed complete resolution of psychotic symptoms after a mean follow-up of 155 months. Long-lasting remissions were seen in all those patients. Chronic mild psychotic symptoms were observed in 30% of our patients.Conclusion. Psychosis due to lupus is an uncommon event that usually occurs early in the course of the disease and is associated with other clinical and biological features of SLE. Long-term outcome appears to be favourable after intensive immunosuppressive treatment. This report highlights the need for prospective multi-centre studies to improve our knowledge and to help establish guidelines for the treatment of this rare complication of lupus.